Obamacare enrollment will hit an estimated ceiling of 14.7 million people over the next several years, according to a report from the Kaiser Family Foundation.
After the end of the third open enrollment under Obamacare, 12.7 million individuals had signed up for coverage, which represents only 46 percent of the potential market, according to the study.
"While marketplace enrollment has continued to grow in the third year of operation, that growth is slower than it was in year two—an increase of 1 million plan selections during 2016 open enrollment versus 3.7 million in 2015," the report states. "A key question for the future of the marketplace is whether enrollment will continue to grow and by how much."
The group estimated future growth by evaluating enrollment data of the 10 states that signed up the most individuals for coverage. They found that the vast majority of their enrollees, 82 percent, were receiving subsidies for their premiums. According to the study, the only way to grow enrollment is to attract those who are not eligible for subsidies and who buy coverage directly.
"If all states improved to at least the average of the 10 best-performing states, we estimate that total marketplace signups would reach 16.3 million," the report states. "Assuming that around 10% of these people would not pay their first month’s premium, this would translate into an "effectuated" enrollment total of 14.7 million. This may provide a reasonable estimate of a ceiling on what marketplace enrollment could grow to over the next several years, assuming current levels of premium subsidies and outreach."
The report finds that enrollment growth has run under Congressional Budget Office projections and says substantial increases in enrollment are unlikely.
"In March 2015, CBO projected average monthly marketplace enrollment of 21 million in calendar year 2016, though recently lowered that forecast to 13 million," the group states. "Even if all states signed people up at the rate of the top 10 states, enrollment would still fall well short of projections by CBO, suggesting that those forecasts may have been unrealistic."
"Absent a substantial boost in outreach or changes to the subsides to make insurance more affordable, substantial increases in marketplace enrollment are unlikely."
In response to this report, the Department of Health and Human Services touted their enrollment numbers. "Last week we announced that almost 5 million new customers signed up for 2016 coverage," said a spokesperson from the agency. "In total, 12.7 million people signed up or automatically renewed their plans for 2016 coverage—more than ever before."